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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Neurologic complications of cardiac operations

Neurologic complications of cardiac operations
Complication Incidence Preventive measures
Brachial plexus injury 2-15 percent Minimize sternal retraction
Attention to patient position
Padding arms
Stroke 0.4-6 percent Conduct of cardiopulmonary bypass
Minimize duration
Hypothermia
Alpha-stat pH management (?)
Minimally invasive procedures (?)
Avoid perioperative hypotension
Preoperative screening
If significant carotid stenosis consider:
Preoperative stent
Combined CEA/CABG
Avoidance of emboli
De-airing maneuvers
Minimize aortic trauma in patients with severely calcified aortas
Monitoring
TEE
EEG/EP (?)
TCD (?)
Ophthalmologic Clinical 0.1-25 percent Same as stroke
Angiography 100 percent
Delirium 3-32 percent Minimize:
Sensory deprivation
Benzodiazepine/narcotic use postoperatively
Disruption of sleep-wake cycles
Watch for metabolic encephalopathies
Electrolytes
Renal dysfunction
Hepatic dysfunction
Watch for withdrawal syndromes
Subtle neuropsychological 10-79 percent Same as stroke
Intracranial hemorrhage <0.1 percent Wait 2-4 weeks after new stroke before surgery if possible
Seizures 0.6 percent Avoid:
Hyponatremia
Hypocalcemia
Hypomagnesemia
Avoid withdrawal of:
Benzodiazepines
Barbiturates
Avoid toxic doses of:
Lidocaine
CEA: carotid endarterectomy; EEG: electroencephalography; CABG: coronary artery bypass grafting; EP: evoked potentials; TEE: transesophageal echocardiography; TCD: transcranial Doppler.
Graphic 68206 Version 3.0

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